Dolphinlee House Home for Older People

Updated 18 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by an inspector, a medicines inspector, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Dolphinlee House Home for Older People is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

The first day of this inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people who used the service and a relative about their experience of the care provided. We spoke with 6 members of staff including the registered manager, one of the provider’s senior operations managers, the activity coordinator and 3 care workers. We reviewed a range of records. These included 6 people’s care records including medication records. We looked at information in relation to the recruitment and supervision of staff. A variety of records relating to the management of the service, including some policies and procedures.

After the inspection

We continued to seek clarification from the registered manager to validate evidence found.

Updated 18 August 2023

About the service

Dolphinlee House Home for Older People is a residential care home providing care for up to 46 people. At the time of this inspection the service was supporting 25 people. The service provides care for older people and people who may be living with dementia and physical disabilities. The accommodation is provided over 2 floors. There are two units on each floor each with their own communal and dining areas.

People’s experience of using this service and what we found

People told us they felt the service was safe. We found improvements had been made since the last inspection to the management of medicines, identifying risks, the training of staff and to the oversight of the quality and safety of the service.

Medicines were being managed safely and people received them as they had been prescribed by staff who had received appropriate training.

Risk assessments were in place to monitor and minimise the potential risk of avoidable harm to people. There were enough staff to adequately support the number of people using the service. Recruitment processes used ensured staff including agency staff were suitable to work with vulnerable people.

Systems were in place to record accidents and incidents. These were consistently monitored to identify any lessons learned, themes or trends. Safeguarding incidents were identified and shared with relevant authorities. People told us they thought the care they received was good and spoke very positively about the staff who supported them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People's care and support had been planned in partnership with them and their relatives where possible.

Documentation used to determine people’s capacity to make certain decisions and establish consent was not consistently completed accurately. We have made a recommendation about this.

Training records demonstrated appropriate and relevant training was completed. Referrals were made to other healthcare services where necessary. People told us they enjoyed the food and their dietary needs were being met.

There were improved, communications, systems and processes used to ensure regular oversight of the safety and quality of the service. The provider, registered manager and staff had worked hard to improve people's experiences and to address shortfalls found at the last inspection driving improvements at the home.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update.

The last rating for this service was requires improvement (published 16 September 2022)

Where there were breaches of regulation and we issued the provider with a notice to improve the safety and quality of the service. The provider also completed an action plan to tell us what they would do and by when to improve the training staff received.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dolphinlee House Home for Older People on our website at www.cqc.org.uk.

Recommendations

We recommend the provider ensures documentation used to establish people’s capacity to make decisions is completed accurately and consistently.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.